Author: Dr. William Rassman

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Proactive Hair Transplants – Hair Loss Information – Balding Blog

My question is perhaps unusual but I feel it is a valid one. I am 33 and I have been experiencing slow diffused thinning over about 7ish years. My thinning started to show in the top of my crown and slowly moved towards the mid and front. I have had no hairline depletion or recession at all.

So I have been on finasteride for about 4 months now. I also had a procedure at another clinic and had a 1.25cm*33cm strip taken and I have high density especially in the back. Anyway, grafting was done basically over the class 6 sort of layout with a back up hairline behind my current one. My total hair count was approx 7,500 hairs. I do have coarse black hair that becomes wavy when long.

Here’s my concern, though I am no where near my final result, what is the merit to doing another say more proactive procedure? That was my original plan but I mean almost in anticipation of the class 6 coming to full reality in my lifetime. Proactive grafting. Thank you in advance, you advice is greatly appreciated.

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Finasteride is the best approach to your future concerns. At only 4 months on the medication, you’re not likely to see much results-wise from it, but stay the course. You could avoid surgery by taking a pill.

I am not an advocate for proactive or preventive hair transplants. My 9 months old granddaughter has a relatively large bald spot on the back of her head. I tease my son about transplanting it, but that is only a joke in a hair transplant family.

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I’m 30 Years Old and Not Much of a Beard – Could Finasteride Slow My Facial Hair Development? – Hair Loss Information – Balding Blog

Dear doctor, I am 30 years old and development of my secondary sex characteristics was always far behind persons of same age. My beard is still not fully developed, I have hairs around my chin and under nose, but almost nothing on cheeks and around ears. I have first noticed starting hairloss about the age of 28 and I started with finasteride treatment. Could this drug affect my beard developing and slow down this process yet more?

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Finasteride does not affect beard hair. I wouldn’t expect you to finally start growing a beard at 30 years old (with or without finasteride). Some men just have patchy facial hair, and that is your genetics.

You can consider doing a hair transplant to your face where the beard is not present if it’s bothering you that much.

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Hair Loss InformationPredicting a Final Hair Loss Pattern? – Hair Loss Information – Balding Blog

Hi Doctor,

I was wondering about predicting final patterns. You’ve explained how this is done by using the densitometer to check for miniaturization in areas where thinning might not be visible to the naked eye. You’ve also said that final patterns usually cannot be predicted with certainty in young men (say, a 21-year-old) because miniaturization could subsequently appear in new areas.

So, I was wondering, is there a particular age at which one’s genetically-programmed final pattern can be ascertained with reasonable confidence? (I realize that people don’t necessarily reach their final patterns.)

Also, do people who are Norwood 3V’s at young ages usually turn into Norwood 6’s? (I was told this.) Or is their hope that Norwood 3V/4/5 could be a final pattern for such a person?

Thank you for all of the amazing information.

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Norwood 3VI don’t believe you can predict your final pattern with absolute certainty, especially in your 20’s. In general, we will say that as you get older into your late 30’s to 40’s, the pattern should manifest. There’s no exact age I can pinpoint.

If you have a Norwood class 3V pattern (see diagram at right) as a 21 year old, these may enlarge with time and could end up as a class 4 pattern. I don’t know that a young man showing a 3V at the present time will usually advance to a class 6.

We try to better assess this with bulk measurements and miniaturization studies.

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Would a Vitamin D Deficiency Possibly Cause Hairline Recession? – Hair Loss Information – Balding Blog

hi doctors from baldingblog.com

How is the new year going so far? My doctor tested my vitamin d levels and it came out i’ve got 13nmol instead of 75nmol. I also have little bone recession in the back, the specialist that found it with photo’s asked if i ever had a accident. I haven’t. I don’t know how long i’m vitamin d deficient, it can be years. My question to you is;

1. Is 13nmol dangerous low?
2. Can it cause little recession in the hairline? Lower quality hair all over? (sometimes i find miniaturized hair in the permanent zone and top, or thick with less pigment, or with strange structures.)

Thank you for your help!

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Unfortunately, I don’t know the answer to your question.

Vitamin D deficiencies are a potential cause of hair loss, but I frankly do not have any experience with vitamin D levels at those reported by you. It sounds like you will be treated for the low vitamin D and you can keep an eye on your hair thickness and progression (or lack of it), for the small amount of recession you see. Even better, you should have your hair bulk checked now and compare it a point down the line when your vitamin D levels are corrected, so that you have numbers along with the visual analysis.

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I’ve Been Using Finasteride for Years and Just Added Rogaine – What Else Can I Do? – Hair Loss Information – Balding Blog

Hello Doc,

I’m 27 year old male on finasteride (aprx 1 mg) for the past 3 years. I have thinning in the Frontal and Crown area. Before starting finasteride I use to lose approximately 100 hairs per day (aprx 30 hairs /day now). I don’t see great results with finasteride however I have retained most of my hair. I’m in the same stage as I was 3 years ago which is a good thing.

A year ago I also started using Rogaine liquid and I haven’t seen any results as well. I’m very consistent with my medication and haven’t missed my dose(99% of time). With respect to side effects I can say may be mild to moderate decrease in Libido, lost some hair in my legs but nothing major.

I’m considering hair transplant to the frontal and crown region to add thickness to my existing hair. I hope there wont be any shock loss as I have been on finasteride for a long time and will continue to do.

I was wondering what else I can do to retain all my hair and maybe grow some in frontal/crown/sides/back area as sometimes I feel my side and back region are also thinning.

Thank you very much.

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I think you are doing pretty much all the right things. Propecia (finasteride) and Rogaine (minoxidil) are the only medications approved by the FDA for the treatment of androgenic alopecia. The next step may (or may not be) a hair transplant, but that would be decided on by a consultation with a doctor.

If the sides and back of your head are also thinning, this isn’t typical of male pattern baldness, so your doctor will have to determine whether you’re even a surgical candidate. Good luck!

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In the News – UCLA Alumni Donated Hair for Children’s Wigs – Hair Loss Information – Balding Blog

Snippet from the article:

Around 200 Bruins and members of the UCLA community dropped by campus for free haircuts Thursday to donate more than 2,300 inches of their tresses to make children’s wigs.

The UCLA Alumni Scholars Club sponsored the fundraiser, partnering for the sixth year in a row with the nonprofit Locks of Love, which turns the hair into wigs for children who have lost their hair due to illness. Long-locked Bruins with 10 or more inches to spare donated their hair with the help of supervised student stylists from the Vidal Sassoon Academy and the Aveda Institute.

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Read the rest — Bruins make a difference for children with hair loss

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Hair Loss InformationDid the Doctors That Claimed ACell Multiplied Hairs Commit Fraud? – Hair Loss Information – Balding Blog

Hello Dr Rassman, I have a question about Acell. No it is not in regards to the effectiveness of the compound, or whether other physicians are still trying to get it to clone hairs. It is in regards to whether the claims made about Acell constitute fraud.

The physicians who popularized the product claimed that it cloned or duplicated plucked hairs. You claimed that you had a in depth discussion with the doctors about their claims where they “retracted” their initial statements about the product be capable of duplicating plucked hair follicles. Is that not distorting experimental results? Is that not illegal?

This whole situation kind of reminds me about Dr Wakefield, a well known researcher notoriously acknowledged for making the outrageous claim that vaccines for measles and mumps cause autism. Vaccines clearly dont cause autism and Wakefields journal entry was retracted by the publishers (something rare I thought). While the situation with Acell maybe a little bit different, doesnt the fact still remain that scientific data was misrepresented here?

I know this blog is not some place to criticize other surgeons/researcher and I am aware that you do not slander other physicians here (an obvious and ethical choice), but I know I am not the only one who thinks that the whole Acell things was borderline fraud. The claims about it were just not scientifically valid. Im out of line here?

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Sometimes doctors jump the gun and get excited about something before it becomes vetted properly in scientific journals, where it can be reviewed by experts in the field. Consumers pay the price as they read hyped Internet advertisements. I said it many times — it is a buyer beware market — and this case is no different. What you read in the Internet is not always the truth.

We tried to adhere to the scientific method and attempted to duplicate the claim by getting approval from the medical board. When we offered it to select patients, we got approval from an institutional review board and never profited from these trials. We actually lost out with the expense from the application fees, materials cost, and our time.

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My Hairdresser Used Peroxide, Then Hair Dye, Then I Relaxed My Hair – Now It’s Falling Out! – Hair Loss Information – Balding Blog

I’m a 19 year old female. I’ve wanted to change my hair color for quiet some time. I wanted to go blonde. When I went to my hairdresser, he told me the implications but I thought oh well let’s do it. I had to peroxide it…I didn’t like the end result so I immediately ordered him to change it…to light brown. I did and my hair was okay until 2 weeks later growth appeared really badly so I decided to relax.

Ever since then, my hair has been falling off. I do apply olive oil and coconut oils & have been treating it for only 3weeks now. I don’t know what to do and I’m afraid of cutting it all of. Is there no other way I can stop it from breaking & having it grow again? HELP

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Hair coloring and chemicals, when used in excess or inappropriately, can cause hair loss. This can be temporary or permanent. If it is temporary, it could take 6-12 months for it to reverse. It all depends upon the degree of burn with the chemicals used. You will know within about one year.

It is a difficult and emotional process to go through and there is no easy answer to this.